With the launch of the 7.9-inch iPad mini,
Apple fired a warning shot across the bow of other hardware
manufacturers with small form factor tablets, in particular, the 7-inch Amazon Kindle Fire and the Google Nexus 7.
While these are competent devices and a little less expensive than the
iPad mini (the Kindle Fire sells for $159 and the Nexus 7 for $199), the
Apple eco-system is a tough competitor in the healthcare sector.

Between September 27 and October 27, 2012, mobile visits to CanadianEMR made up 10% of the total with 43% from iPads
and 37% from iPhones. Over the same one-month period (September 27 and
October 27, 2011), mobile visits made up 4.9% of total visits to CanadianEMR (40% from iPads and 30.8% from iPhones). In one year,
mobile traffic to CanadianEMR has doubled and
the percentage of visits that occurred using Apple devices has increased
from 70.8% to to 80% over the same one-month time frame.

Physicians love their Apple devices. Tablets are becoming ubiquitous
in both clinic and hospital settings. The high resolution retina
displays provide crystal clear resolution for viewing X-rays and other
diagnostic images and the form factor appears to be just right. So, how
does one improve upon an already successful product, particularly in an
area as demanding and competitive as healthcare?

I believe that the iPad mini will do just that. At 7.9 inches, the
screen is large enough to comfortably view the majority of information
that a clinician will need and, although it may require more work to
navigate around an EMR, the convenience factor cannot be underestimated.
The iPad mini is the right size for many day-to-day clinical functions.
It is a mobile prescription pad (watch for an acceleration in the
development of prescribing and medication management applications), it
is a note reviewing device (much easier than trying to use an iPhone), and it is good enough for data entry, particularly with EMRs that have
been customized for the iPad form factor.

At $329 for a 16 GB WiFi version, it is also affordable enough that I
can see many clinicians having one, in addition to their iPhone or
regular iPad. Most importantly, it will fit in one’s jacket pocket with
ease, making for truly portable computing. I am excited about the new
iPad mini and will purchase one as soon as I no longer have to stand in
line at the Apple store. Or maybe, I will just order online.

What do you think about the iPad mini? As a clinician, would you purchase one?

Physicians are mobile workers. Some may work in more than one practice location; others may use multiple examination rooms in a single clinical setting. However, one feature common to all physicians is that they move around during a clinical examination. Unless a physician has an administrative job, they are usually not restricted to a desk and a single computer. This creates certain challenges when it comes to hardware in the examination room and throughout a medical practice. A good needs analysis is necessary to determine whether one should have a wireless or wired local network, or a combination of both.

With the growth in availability of smaller, faster, and lighter wireless tablets from a wide range of manufacturers such as Apple and Samsung, and mobile phones with larger screens (the new Samsung Galaxy S3 has a 4.8 inch HD screen), physicians now have more choice than ever regarding tools that fit the mobile form factor. Wireless networks and access points have matured significantly over the past five years and bandwidth is generally no longer an issue unless one is accessing extremely large files, such as radiology images. The new Apple iPad with retina display is being used increasingly in hospitals to view images due to the high resolution screen and there have been regular reports of a soon to be released Apple iPad with a 7–8 inch screen. Sure to be a hit for physicians who do a lot of prescribing.

However, there are some important steps that you should follow if you plan to install a wireless network in your medical practice:

Talk to your existing (on intended) EMR vendor to ensure that their EMR product works well on wireless networks and what the minimum bandwidth requirements might be. This may be your primary determinant as to whether you go with a wireless or wired network implementation.

Wireless may be your network of choice if you are using an ASP- or cloud-based EMR. In these types of systems, the EMR is hosted outside of your practice at a remote location and is accessed through the Internet or a secure network connection.

Unless you have a very small office space that requires a single wireless access point and you are comfortable installing it and setting up the wireless security, bring in an expert to do the installation. They will ensure that you have sufficient wireless coverage throughout the practice, install signal amplifiers (if needed), and will set up your wireless security for the maximum level of protection.

Do not install an unsecured wireless access point in your practice that is connected to your office computer(s). Using sniffer software, it is possible for hackers to easily gain access to your system and anyone else who connects to the network within your practice.

Wired networks:

If you are running a server in your practice, you certainly can install a wireless router, but this is something that will require consultation and advice from your vendor. Wired networks have some distinct benefits. They are fast, stable, and have high availability. They are also secure in that your practice can function as a closed environment if you are not connected to the Internet or an external network. If you are connected to the Internet, you will need to install a firewall (as you would with any wireless network). Wired networks also tend to be more costly to install initially and do require maintenance and some ongoing cost.

Have you had any experience using wireless access points in your practice? Share your thoughts by clicking on the “Comments” link below.

One of the most common questions physicians ask is what type of hardware should they purchase for their practice and EMR. But hardware should not drive the choice of software. The first and most important piece of advice is to talk to your EMR vendor to determine the technical requirements of their system and any recommendations they have regarding hardware for your practice. There are a wide range of choices to consider when selecting hardware depending on your practice and how much mobility you require in terms of your computing requirements.

Laptops vs. Desktops

One of the benefits of desktop computers is that they are relatively inexpensive and can be fixed securely in specific areas. In comparison to laptops and other mobile devices, they are more difficult to steal. It is also easier to replace keyboards or monitors if they are damaged. How should you position your computers in the exam room to ensure maximum interaction with your patients? Read this blog post for guidance on integrating computers for maximum patient benefit. In addition, you should consider the layout and integration of computers from the perspective of ergonomics and human factors in order to avoid medical conditions commonly faced by computer-dependent workers — such as eye strain from long hours looking at a computer monitor or carpal tunnel syndrome from repetitive strain injuries. Fortunately, most physicians are quite mobile in their practices and seldom work in a single position for extended periods of time.

Another resource section on CanadianEMR is medical office configurations with images of practices that have implemented EMRs including example layouts. Different individuals may have different preferences regarding the hardware that works best. For example, exam rooms may be assigned to each physician, in which case there may be the ability to customize specific rooms for special needs. The downside of too much customization is that it becomes more difficult to replace equipment or keep office furniture interchangeable, if items need to be replaced. Laptops are available in a number of formats ranging from the new light ultrabooks, Macbooks, more traditional laptops, or those that have touchscreens such as the HP ProBook Notebook and the Toshiba convertible laptops. Touchscreen laptops allow users to combine screen selection in addition to using a keyboard or touchpad. However, you should check and confirm that the laptops will offer decent battery life. There is nothing more frustrating than a computer that shuts down midway through a shift because the battery has died.

Tablet Computers & Mobile Devices

The prevalence of tablets such as Apple’s iPad and the Samsung Galaxy tablet have created a lot of excitement amongst healthcare providers. The iPad is the undisputed leader in healthcare, particularly with the recent release of the high resolution retina display. Tablets are relatively inexpensive and provide a comfortable and more natural mechanism to document encounters due to the form factor. When considering this type of device you will need to check with your EMR vendor to ensure they are supported and whether they offer full or limited functionality.

Many clinicians also like the ability to use smartphones such as the iPhone or Samsung Galaxy series phones to access certain parts of their EMR. If you use a web-based EMR that requires a browser plus a username and password you may not require additional apps or functionality. However, your view will be limited due to the small screen size. Devices such as the Samsung Galaxy Note are larger phones that are beginning to bridge the gap with traditional tablets. If you use mobile devices to access clinical information, make sure that you lock your device(s) and have an ability to “remote wipe” them in the event that your device is lost or stolen. Expect to see different sized devices in the next 12 months as tablets begin to service different sectors of the market. For example, although the traditional iPad is too large to carry in one’s coat pocket or hold with a single hand, devices that provide screens in the range of 7"–8" are going to become more popular. As with everything mobile, the device is important, but the App ecosystem is increasingly becoming the determining factor. Software is driving the hardware selection. Now, where have I heard that before?

If you would like to comment on this post, add your thoughts by click on the “Comments” link below.

When Facebook purchased Instagram recently for a record $1 Billion, it sent a shockwave through the technology industry. A mobile App without a revenue stream (but 30 million users) was valued so highly that it created instant multi-millionaires out of its founders and established a new frontier for the next series of blockbuster products and applications. Who could have anticipated that a relatively simple application such as Instagram, which allows individuals to share photographs with their friends and peers, could be worth so much? Android and Apple have developed the dominant App ecosystems with strong evidence that the range and variety of products will continue to grow, fueled by events such as the Instagram purchase.

In this setting, consumers are the beneficiaries. Anyone who owns an Android or Apple device already knows just how useful it is to be confronted with a question or problem, be able to search the App store for the respective device, and find either a free or low-cost application that immediately solves that problem.

The reason that I would like to focus (pun intended) on photo apps is that physicians are using cameras increasingly in their practices to document skin lesions, pre- and post-surgical status of patients, wound healing, orthopaedic deformities, and other medical conditions. One of the challenges for physicians is having a camera available in the examination room when you need it. A digital camera is not a device that a physician generally carries around; however, with mobile phone cameras improving in quality, that is no longer the case. Most physicians do have a mobile phone with them at all times and the ability to use the phone as a medical documentation device (with flash in many cases), adds to the clinician’s flexibility. From a privacy perspective, it is important to delete images from the phone after they have been transferred to the EMR. The quality is quite astounding and should be adequate for basic documentation needs.

So, what Photo Apps do I have on my iPhone 4S? The screenshot below shows applications that I most commonly use.

I use a number of editing and camera Apps, including the standard iPhone camera, but had always been disappointed with the quality of the images. Not bad, but not great. That was until recently when I became aware of the 645 PRO app from Jag.gr. This camera App allows one to take advantage of the very good lens on the iPhone 4s without losing much quality through compression software that is usually automatically applied to images saved in .jpg format when using the standard camera. Using 645 PRO, one can set the quality level and save the image in “near lossless” format. In other words, exactly as the image is captured without software manipulation. The down side: large images up to 10MB in size, but — with unlimited storage at relatively low cost — that is not generally a problem. The image below was taken with the 645 PRO camera on an iPhone 4s.

Original Image

Detailed Section

Have you had an opportunity to use your mobile phone in order to capture clinical images? Click on the “Comments” link below to share your experiences.

The rapid transition to EHR and the integration of information technology in the delivery of patient care has had a transformational impact on medical offices and hospitals. There are many positive effects of the technology, including rapid access to laboratory information, diagnostic reports, and medication histories. However, there is also a potential dark side to the technology. Earlier policies dictated that in order to use a device on a hospital or health system network, it had to be “approved” by that institution. Enterprise-wide implementations meant that both administrators and clinicians had little choice over the mobile devices that they used. This was in large part the formula behind the success of the RIM Blackberry. Devices were secure, they could be managed through the organizational network, and could be controlled in terms of both the messages they were able to transmit and receive as well as the content.

The success of iPhones and Android mobile phones began to crack open the RIM business model in the last few years, primarily driven by Apple products. Executives as well as clinicians began demanding that they be allowed to bring their own mobile devices into the hospital or large clinic and connect them to the network. While this created some security challenges, it also solved a financial problem for large IT departments. Rather than purchase hundreds or even thousands of hyper-secure devices that had to be managed by the organization, clinicians and staff started being encouraged to bring their own phones (and tablets) to work. Using secure protocols as well as apps that allowed them to view and interact with hospital or other clinical data, this has become the standard business model. Maintenance costs are lower for IT departments, as they no longer have the responsibility of owning the devices. In addition, the flexibility offered by mobile apps provides increasingly more sophisticated ways to access clinical information. What hurt BlackBerry (in addition to poor performance in the last five quarters) was the shortage of available clinical and non-clinical apps to meet the needs of users.

However, with mobile devices functioning as both work and social tools, it has become increasingly more difficult to separate the two functions. What happens when a personal text message arrives while doing rounds or entering orders into a patient chart? It is very tempting to respond to these types of messages as they pop up in front of one’s current application and to launch a response simply involves clicking on a button or link. It takes a great deal of personal discipline to separate these two roles, especially as the content is delivered through the same device... continuously.

An article on this topic in Kaiser Health News recounts the experiences of Dr. Feldman at Beth Israel Deaconess Medical Center and Dr. John Halamka, the hospital’s chief information officer. Dr. Halamka has written a case study for the Agency for Healthcare Research and Quality (AHRQ), which describes an incident in which a patient who was on anti-coagulant therapy was to have his Coumadin discontinued prior to surgery. However, a resident forgot to stop the medication due to distraction from an incoming personal text message.

The case study and article are well worth reading — in particular as a warning of the potential risks when mixing business and pleasure through one’s connected personal mobile devices.

What are your thoughts? Should mobile devices be strictly controlled when used in clinical settings in terms of messaging and available applications? Is this even possible in 2012, and should strict policy rather be used to manage these types of risks? Add your comments below.

Despite the effort to create paper “light” medical offices, the likelihood (in the forseeeable future) that all data is going to flow electronically is extremely low. In fact, some would argue that we manage more paper now than in the past, with the exception of lab results. The reality is that medical practices manage an enormous number of paper documents in the office in the form of referral requests, consultation reports, historical patient data, diagnostic reports, and reports from third parties. All of this information has to make its way efficiently into the EMR and documents generated by the EMR (such as prescriptions and handouts) have to be provided to patients, medical colleagues, and a multitude of additional individuals.

Thus, the need to have good printers and scanners at one’s disposal to manage these documents is extremely important.

When thinking about document scanning management needs, I would suggest dividing documents into two distinct categories:

Documents that need to be stored and archived for historical purposes. For example, old charts for which a summary may have been entered into one’s EMR, but the original documents have been stored based upon the provincial record storage guidelines.

Documents generated on a day-to-day basis in the management of patient care.

Each of these document categories has different scanning requirements. It is impractical to use a small office-based scanner to enter and archive thousands of historical paper charts. In this instance, I would recommend using a commercial organization that has the equipment to scan these documents quickly and efficiently, can guarantee the media that are used to store the digital files will not degrade, and can securely dispose of the paper documents after scanning, if that is desirable. While this is more costly than having a family member or student scan the documents one page at a time, the accuracy and quick turnaround are worth the effort, plus you will no longer have to pay for storage. This is an important consideration if you are closing your practice and would like to be able to transfer patients to a colleague. Receiving a digital copy of a patient’s record is more desirable than a thick paper chart.

For day-to-day scanning of documents, there are a number of excellent small footprint scanners made by Fujitsu (ScanSnap series) and a wide range of scanners from Hewlett Packard. While it may be tempting to purchase a $100 scanner from your local Best Buy, the likelihood that this will meet your office needs in terms of volume and output format are small. Spend the extra money and make sure you have an industrial strength scanner that is going to provide years of service. Your staff will also be appreciative.

What is new in printer technology? Greater print efficiency and wireless capability are some of the most important considerations. Small footprint printers that can easily be installed in an examination room are desirable if you would like to print and hand information to a patient without disrupting the clinical encounter. If you have to walk out of the exam room to collect every document that is printed, it can be very disruptive to patient care. If you elect to install inkjet printers, expect the ongoing maintenance costs to be higher than an equivalent laser printer. It may be cost-effective to install a number of multifunction printer/scanners in your medical practice wirelessly connected to a network. For example, in the doctor’s common work area or as an additional scanner/printer should the primary scanner be in use. Brother makes an excellent series of wireless multifunction printers. Remember that if your office is dependent on a single multifunction printer/scanner and the device fails, you lose all of your devices at the same time. It is best to keep a spare in reserve in case of emergencies.

Have you had any experiences with printers or scanners that you would like to share? Click on the “Comments” link below to add your thoughts.

Walk into any emergency room and you will see a plethora of connected devices attached to patients, beeping and displaying blood pressure and other vital signs on a continuous basis. Similarly, in the operating room, an anaesthesiologist has a completely integrated suite of equipment that collects, stores, and displays vital information for immediate action if needed.

This is the promise for EMRs — the ability to have the mundane and repetitive tasks of measuring vital signs collected and immediately integrated into the EMR. All without any further effort other than connecting the cuff or monitor to the patient. Now, that would be a real time saver, and would also reduce inaccuracies related to entering data into the EMR. While this seems to be a logical next step for EMRs, there are some challenges and points to consider with regard to connected medical devices.

Integrating devices into an EMR is a costly and time-intensive process. While there are standards that have been developed, each EMR has a proprietary database and structure. As a result, building and maintaining the EMR interface requires ongoing commitment by the vendor, particularly as new versions of the EMR software are released.

Not all integrated devices are the same. The integrated devices market varies country by country. In the United States and Canada, the market is dominated by Philips, Welch Allyn, and GE with the majority of devices more focused towards the hospital setting. In addition, the amount of interface development with a specific EMR system can result in significant differences in the way the data is presented in the EMR.

An important first step is to do a careful workflow analysis in your practice to determine what you need. For example, if your computers are fixed in each exam room and you can plug each device into a computer, you may not need wireless connected medical devices. This can significantly reduce the cost of connecting devices to your EMR.

What kind of connected devices are available? The majority of devices for the EMR tend to be for vital signs monitoring (BP, Pulse, Temp, SpO2). A wider range of devices are available for cardiologists; however, beyond that a very limited selection is available.

Even if your EMR vendor does not yet offer integration with connected diagnostic devices, share your needs and desires. As with the tablet market, it took Apple getting the iPad right before we saw a widespread availability of tablets. I expect the same to happen once we have some exceptional connected devices.

Do you use any connected devices with your EMR? Click on the “Comments” link to share your experiences.

It was not that long ago that fax machines were the hot new technology for business and medical practice. Instead of mail and hand delivery, documents could be moved around securely by fax. With the adoption of EMRs, the deluge of faxed diagnostic results, referral requests, and consultation reports may have slowed slightly; however, we still live and work in a predominantly paper world. Without a mechanism to easily digitize these paper documents, a staff member needs to scan previously mailed or faxed reports, save them in a folder, and attach them into an individual patient's electronic charts. A software application called a Fax Server is designed to take over (to a large degree) the functions of your standalone fax machine. For a more detailed description of fax servers, click here (Source: Wikipedia).

Fax servers can send and receive documents, although you may not want to completely retire your traditional fax machine. Because the fax server functions as an application through a desktop computer (unless you have a very efficient scanner), sending multi-page documents such as referral requests through your fax server may be disruptive to staff. Keeping the traditional fax machine for some outgoing documents is a good strategy. If you are able to generate referrals through your EMR, these can often be sent directly using the fax server to a destination fax.

Another form of fax server is "Fax over IP" or Internet fax. Using one of these services, you can easily receive faxes via the Internet that are then delivered to you as documents attached to an email. Although not as easily usable as a fax server that runs directly off your laptop or desktop computer, these services provide great convenience, particularly if you are mobile and like to have access to your faxes from multiple locations. A popular service is MyFax.com, although there are many others. Prices are reasonable and usually volume based, and it is also a cost-effective way to obtain a toll-free fax number.

Document management is a critical part of the day-to-day work in a medical practice. As a result, you should have a detailed conversation about fax server software with a potential EMR vendor as part of the selection process. Different vendors may have different approaches, and it is important to understand the implications to your staff's workflow if the fax server is directly integrated with the EMR vs. a standalone service on the desktop computer. There are a number of steps in order to electronically receive and attach a document in an EMR. One step that deserves additional discussion with your EMR vendor is how the documents are named when they are received using the fax server. The fax server software may automatically generate a unique ID for each document received. It is then up to your staff to open the document, identify the patient name and contents, and then rename the document prior to attaching in the patient's chart. Your vendor may have a creative approach to managing this mundane and time consuming task.

If you are currently using an EMR and do not have a fax server, or if you are considering an EMR, the fax server is a simple, cost-effective tool that makes document management easier and more efficient.

Along with millions of Apple converts, I have been following the announcement of the new Apple iPad at a live event in San Francisco. I have been tracking ABC News’ Joanna Stern via her live blog of the event. The majority of the announcements have been focused on the iPad’s enhanced processing power, the 2048 x 1536 resolution retina display, 10-hour battery life, higher resolution camera, and high-speed 4G LTE connectivity. Healthcare is likely to be a major benefactor of these features. Here is how I see the new iPad being adopted by clinicians.

The higher resolution and faster processing speed of the new iPad will drive a wide range of uses in healthcare. In addition to functioning as inexpensive devices providing quick access to information at the patient’s bedside (Ottawa Hospital goes Digital), the ability to view medical images such as diagnostic investigations (MRIs, CT scans, etc.) with sufficient resolution to make diagnostic decisions is likely to spur another round of purchasing by radiologists and other diagnostic specialties.

Data input is still a challenge in EMRs, particularly if limited to drop-down lists and menus. However, the benefit of being able to run an EMR on an iPad or a tablet form factor in conjunction with a 10-hour battery life makes it a very good alternative to the traditional paper chart. Even if not used as a full-fledged version of an EMR (the version a doctor may use in the examination room), iPad (or tablet) versions of the EMR could function very well as information viewers or information capture devices, particularly if they integrate speech recognition software. I could see specialties such as dermatology or plastic surgery using an iPad to document skin lesions or pre- and post-surgical status with capabilities to quickly integrate the images into the EMR without a separate (and time consuming) tagging process.

The benefit of built-in 4G LTE (Long Term Evolution) mobile network connectivity provides the dual-redundancy that practices have been looking for with cloud-based EMRs in which the data and applications are accessed using an Internet connection. Let me explain further. One of the challenges faced by EMRs that operate over an Internet connection is the risk of the broadband connection going down for a period of time. In a situation where a single Internet connection is the only way to connect to the database, this could be very challenging for a practice. As a result, expensive workarounds have included installing a second Internet connection as back-up in case the first goes down. In an ideal situation, one would never have to take advantage of this dual-redundancy; however, it is designed to work in the event of an unexpected failure. With 4G LTE enabled iPads, if they functioned using the practice’s standard wireless Internet connection and that connection went down, the iPad could simply switch over the 4G LTE network, which should provide sufficient speed to enable a seamless user experience. The likelihood of both a land-based Internet connection and a wireless 4G LTE network going down simultaneously is very small.

Finally, what I wanted to hear today (but did not) was the announcement of a smaller form factor for the iPad in addition to the standard 9.7 inch version. Something that could fit easily into a doctor’s white coat pocket. Seven inches would probably be ideal. Even though Apple did not announce the 7-inch version today, I hope that this version is in the works, as it would be an ideal compromise between the iPhone and the current iPad. We can only wait and hope!

What are your thoughts about uses in healthcare for the new iPad? Add your ideas and feedback by clicking on the “Comments” link below.

The following guest editorial was submitted by Dr. Allan Horii, a Richmond, BC family physician, regular contributor to CanadianEMR, and longtime EMR User.

It seems tablets are in vogue again.

Thanks largely to the success of the iPad, consumers have embraced the “tablet” or “slate” format of computing. What’s often overlooked is that tablet PCs had been available for a number of years prior to the introduction of the iPad. Adopted primarily by vertical markets, such as healthcare, these computers never enjoyed widespread success because they were too heavy, battery life was poor, and the Windows operating system didn’t seem to provide an elegant way to interface with the tablet. The iPad was revolutionary in that it showed that a device could be light, intuitive to use, optimized for touch input, and provide long battery life. We are starting to see the iPad make more in-roads into the health sector, with new medical apps, and physicians and hospitals adopting the device into their workflow. However, many current EMRs still depend on the Windows OS to function.

I’ve been a strong proponent of tablet PCs for use with EMRs. There has been a steady evolution in the technology since I first began using them around seven years ago. Processors are becoming more powerful and energy efficient, battery technology is improving, and weight is decreasing. The greatest quantum leap I’ve seen thus far has been Samsung’s recent offering, the 700T Series 7 Slate. I have to say it’s the most impressive Windows-based tablet device I’ve ever used. The Series 7 slate weighs a mere 0.87 kg (1.91 lb) on my scale. That feels like an immense difference in hand, roughly half the weight of my last two tablets (the Lenovo Thinkpad X201 and the HP Elitebook 2730p). It has a bright 11.6” LCD screen that supports both touch input and a Wacom digitizer pen. Its slim, 1 cm profile holds an Intel Core i5-2467M processor running Windows 7 (64 bit), with 4 GB of RAM and the option of a 64 or 128 GB SSD drive.

This device works well with my EMR. I can navigate screens and menus with either my finger or the digitizer pen. Handwriting recognition thus far has been excellent. Battery life has also been very good: 5+ hours running Wi-Fi. I’ve always enjoyed the fact that a tablet PC allows me to remain engaged with patients while using my EMR; I can access my patient file and still face the patient, just like the old days with my paper chart. The pen also gives me an additional tool to enter information: for example, simple diagrams of physical exam details can be drawn, or pre-generated figures provided by the EMR can be marked up with more precision than a mouse. The tablet has a 3 megapixel rear camera which comes in handy for recording images of skin lesions, etc. A docking station and Bluetooth keyboard are also available if a desktop-like setup is periodically required .

Samsung has indicated that they will be shipping this tablet with Windows 8 loaded on it next year. That promises to be a further improvement, because Windows 8 has been optimized for touch with its Metro interface. In any case, the release of this device bodes well for tablet advocates, like myself. I’m very excited. I hope we will see similar designs and further improvements in the near future.